The human spine is an essential load bearing component in the human skeleton. Damage to the spine may render the injured person uncomfortable, disabled or incapacitated. Any injury to the spine will likely cause at least some discomfort, immobility or pain.
Spine injuries are common. Statistics indicate that about one in every four adults suffers at some point from back or back-related problems. Many injuries of the spine occur in the lumbar region of the spine. In common everyday activities, such as lifting, sports, extended sitting, and at work, the lumbar spine is exposed to stress, and consequently to injury or re-injury. In certain activities, particularly occupational activities, stress, including torsional stress, may be repeatedly applied to the spine.
The lumbar spine can be injured in essentially two ways--namely, excessive compression or excessive torsion. If the former occurs, the most common result is a damaged vertebral end plate. The lumbar spine is relatively resistant to compression injury. The remedy is preferably rest. Corrective surgery is rarely required.
If excessive torsion or twisting occurs, the most common result is a damaged intervertebral disc. In extreme cases, the nucleus of an injured disc may rupture the annulus of the disc and protrude therethrough. Such a protruded disc, or "slipped disc" as it may colloquially be called, may pinch the spinal nerves causing extreme leg pain, or even paresis or paralysis. Corrective surgery to remove disc protrusions or even entire discs may be required. A series of relatively minor torsional injuries, if not properly identified and allowed to heal, may result in a significantly weakened disc, which may be susceptible to more serious injury. The lumbar spine is more susceptible to injury by torsion than by compression. Continued twisting toward an injured side may aggravate the injury and interfere with the healing process.
Torsion injuries can occur independently in the two rotational directions.
Some injuries can, of course, involve some combination of the above basic injury modes.
If a patient complains of back pain, it is critical that a proper diagnosis or assessment of the spine be made in order to determine whether there has been any injury to the lumbar spine and, if so, the nature and extent of the injury. Depending on the true nature of any injury, then different treatment regimens will be prescribed. The problem is that, practically speaking, it can very difficult for a medical practitioner to assess the condition of the lumbar spine and the precise nature of the injury. Very few tools are available to assist the medical practitioner in conducting the assessment.